There have been other threads similar to this, but I'm wondering solely about RN to pt ratios, not including however many LVNs, PCTs, or CNAs are included in your staffing.
Our hospital doesn't take into account the number of pts 1 RN is responsible for when staffing, even when they have their own pts, and are responsible for the other non-RN staffs' pts, also. It is kinda scary sometimes when you are so busy with your own full pt load (or should I say 'overload'), that you may never lay eyes on another nurses pts that you are 'legally' responsible for, too. There may be 17 or more pts on the floor (med/surg) some days with only 1 RN, and these are acutely ill hospital pts. It's not humanly possible to do what is required or expected of nurses sometimes. Is this very far off from the rest of the country, or is this pretty much normal everywhere? (I hope not.)
Unfortunately, these ratio laws in CA may be changing (for the worse:crying2: ) Hospitals are crying and now accusing the closure of their facilities on NURSES! They are telling the public that they cannot afford these pt/nurse ratios and this is what is forcing the closure of ERs and hospitals. Yup, blame the nurse....not the totally messed up healthcare system in this country. I just read an article in the paper that said, "If nurses would just take 7-8-9 patients, our facilities wouldn't be in the middle of this crisis". It implied that Nurses are just sitting around twiddling their thumbs. What to do, what to do??
Many facilities I go to will load me with 5 very high acuity patients, the frequent flyers that the staffers refuse and NO CNA!!! The hospital is not required to provide any nursing help. If I work at a facility that incorporates LVN's into the ratio, I am also responsible for assessments, IVP and taking MD orders so that makes me responsible for 10.
May I also say that the headlines screaming "NURSING SHORTAGE!!!" are bunk, expecially in Southern California. I will say it again, there is no nursing shortage, just a shortage of desirable nursing jobs (thanks Matts Mom!)
I work in philly on a pediatric trauma/transplant floor and the ratio is 5 pts : 1 RN sometimes smaller if its a new transplant they are a 3:1 or a 4:1 and depending on the trauma and stuff plus we have an aide sometimes thats 10:1 ...so basically we have 2 nurses (2RN or 1RN and 1LPN never 2 LPN) for 10 patients and sometimes we have an aide but most times not.
Is California the only state that has nurse/patient ratio laws?
unfortunately; some individual hospitals throughout the country might actually believe in patient safety, but because you can't count on that from hospital admin, it's law in CA
I agree RUN!!!!!!!! I was recently put in an unsafe staff position, and quit the next day. I moved across the country from a large 33 bed ICU to a small 8 bed one. Here they use LPN's as primary staff. I was aware of that, however I was not aware of the degree to which they were used. After I had a 6 day orientation, with one day as regular staff, I was placed in charge of the unit as the ONLY RN IN ICU!!!!!!!!!!! :eek: :angryfire !!!!! Scary:chair: to me to be there with NO backup. Now the charge thing I could handle remember I am many years experienced in a much larger unit with charge experience at my previous facility. The thing that bothered me the most was that if something went down I was the ony RN. Administration here seems to think that is fine but it is not with me.. I would like to keep my license for a few more years. Protect yourself NO ONE else will!!!!!!!!!!! PS I was not even fulltime staff only used prn:uhoh3:
I work on a 32 bed med-surg/tele floor on the night shift (in Texas). We typically have 3-5 nurses including 1 LVN (who can do a hell of a lot); and a CNA. The CNA is "convenienely" designated as a PCT (pt care tech) however. On a good night, we have a 1:5 ratio; on a typical night, we run 1:6; on a particularly bad night, we'll go to 1:8. I have heard that we have gone to 1:9 occassionally, but it's a rare thing fortunately. Acuity is just beginning to be addressed; unfortunately, they're all pretty high acuity in their own way. The charge nurse is expected to take PT's, be they new admissions or curent Pt.'s.
how i envy you all!!! here in brownsville, texas we are forced to handle minimum of 1:13 patients in the med surg floor with different acuities and having even some patients who should be in PCU. It can even reach up to 18 patients!!!! I am so fed up and dead tired, my back aches so much that i cannot get up for the next days duty. i am likewise worried for my patient and for my license. we are slaves here left with no choice but to finish our contracts since if we decide to buy out our contracts we need to pay a breach of contract like for 12thousand dollars. what's worse we get cancelled with no pay if census goes down. help!!!!!
I agree RUN!!!!!!!! I was recently put in an unsafe staff position, and quit the next day. I moved across the country from a large 33 bed ICU to a small 8 bed one. Here they use LPN's as primary staff. I was aware of that, however I was not aware of the degree to which they were used. After I had a 6 day orientation, with one day as regular staff, I was placed in charge of the unit as the ONLY RN IN ICU!!!!!!!!!!! :eek: :angryfire !!!!! Scary:chair: to me to be there with NO backup. Now the charge thing I could handle remember I am many years experienced in a much larger unit with charge experience at my previous facility. The thing that bothered me the most was that if something went down I was the ony RN. Administration here seems to think that is fine but it is not with me.. I would like to keep my license for a few more years. Protect yourself NO ONE else will!!!!!!!!!!! PS I was not even fulltime staff only used prn:uhoh3:
I will repeat what I have said, time and time again- LPN/LVNs have no place in a Critical care Area, or the ER for that matter. Their education and scope of practice precludes them being placed in these staffing situations. Period. It is for the safety of the patients. It is not to make an LPN/LVN feel good by placing them in an environment in which their education, and scope of practice (or lack therof), precludes them from providing safe patient care in that type of environment. They have no business working in an ICU.
:eek: :angryfire !!!!! Scary:chair: to me to be there with NO backup. Now the charge thing I could handle remember I am many years experienced in a much larger unit with charge experience at my previous facility. The thing that bothered me the most was that if something went down I was the ony RN. Administration here seems to think that is fine but it is not with me.. I would like to keep my license for a few more years. Protect yourself NO ONE else will!!!!!!!!!!! PS I was not even fulltime staff only used prn:uhoh3:
JennRN&Mom23
12 Posts
We do 8 hour shifts, primary nursing. So on days whether it's an RN or RPN..the ratio is 4:1, evenings is 5:1 and nights is 8:1.